Journal of Surgery Concepts & Practice ›› 2020, Vol. 25 ›› Issue (01): 29-34.doi: 10.16139/j.1007-9610.2020.01.007
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ZHANG Ti(
), YANG Xuejiao
Received:2019-10-25
Online:2020-01-25
Published:2020-02-25
Contact:
ZHANG Ti
E-mail:zhangti@tjmuch.com
CLC Number:
ZHANG Ti, YANG Xuejiao. Occurrence and treatment of hypertension associated with targeted therapy in hepatocellular carcinoma[J]. Journal of Surgery Concepts & Practice, 2020, 25(01): 29-34.
| 药物 | 机制 | 靶点 | 所有高血压（%） | 中、重度高血压（%） |
|---|---|---|---|---|
| 索拉非尼[ | TKI | VEGFR2-3, Raf-1, B-Raf | 18.8 | 2 |
| 瑞戈非尼[ | TKI | VEGFR1-3, PDGFR, c-kit, RET, Raf-1 | 31 | 15 |
| 伦伐替尼[ | TKI | VEGFR1-3, FGFR1-4, PDGFR, c-kit, RET | 42 | 23 |
| 卡博替尼[ | TKI | MET, VEGFR2, RET, AXL, FLT3 | 29 | 16.3 |
| 布立尼布[ | TKI | VEGFR,FGFR | 27 | 5.3 |
| 利尼伐尼[ | TKI | VEGFR, PDGFR | 20.8 | - |
| 舒尼替尼[ | TKI | VEGFR2, PDGFR, c-kit | 20.9 | 3.8 |
| 多韦替尼[ | TKI | VEGFR, PDGFR | 22 | 13 |
| 阿昔替尼[ | TKI | VEGFR1-3, c-kit, PDGFR | 54 | 26 |
| 西地尼布[ | TKI | VEGFR1-3,PDGFR | 41 | 29 |
| 雷莫芦单抗[ | IgG1 | VEGF | 25 | 13 |
| 贝伐单抗[ | IgG1 | VEGFR2 | 33 | 15 |
| 项目 | 药物类别 | 代表药物 | 注意事项 |
|---|---|---|---|
| 首选 | 二氢砒啶类CCB | 氨氯地平 非洛地平 （除外硝苯地平） | 腿部肿胀 起效缓慢 |
| ARB | 缬沙坦 氯沙坦 厄贝沙坦 坎地沙坦 | 肾血管疾病 周边血管疾病肾功能不全 肾脏化学疗法间隙 高钾血症 | |
| 次选 | 利尿剂 | 螺内酯 氢氯噻嗪 | 痛风 高钾血症 低钾血症 QTc延长药 |
| β受体阻滞剂 | 比索洛尔 美托洛尔 | 心动过缓 心脏传导阻滞 哮喘或慢阻肺 | |
| 避免使用 | 非二氢吡啶类CCB | 维拉帕米 地尔硫卓 | 影响VEGF抑制剂血药浓度 |
| ACEI | 卡托普利 依那普利 培哚普利 | 促进肿瘤生长 | |
| 血压监测 | 停止降压治疗后定期监测有无反弹性低血压 VEGF抑制剂停止应用或减量后定期监测血压 | ||
| 可发展药物 | NO供体 | 莫斯多明 硝酸异山梨酯或单硝酸异山梨酯 西地那非 | |
| ET-1抑制剂 | 马西替坦 | ||
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